Tag Archives: health impact

“All the lonely people” – tackling the epidemic of loneliness

Posted on by

Prior to the coronavirus pandemic, the UK was already experiencing what had been described as an ‘epidemic’ of loneliness.  The various lockdowns and social restrictions that were put in place to reduce the spread of the virus have exacerbated this already troubling situation.

Indeed, according to recent research by the Mental Health Foundation, 1 in 4 UK adults (25%) have felt lonely some, or all of the time, over the previous month; and 1 in 4 UK adults (25%) felt ashamed about being lonely.

With the huge impact this can have on mental health, it’s no surprise the theme of this year’s Mental Health Awareness Week was loneliness.

In its new report, “All the lonely people”, published as part of Mental Health Awareness Week, the Mental Health Foundation explores the clear links between loneliness and mental health, looking at what it’s like to be lonely, the causes, consequences and the groups of people who are more likely to experience severe and enduring loneliness.

All the lonely people

Through sharing the stories of nine individuals who often or always feel lonely, “All the lonely people” highlights the circumstances, situations and life events that can increase our risk of loneliness. It also investigates how well people understand loneliness and suggests ways that we can respond as individuals and across society.

While it is acknowledged that anyone can feel lonely, there are a number of risk factors that can increase the chances of severe and lasting loneliness that can impact mental health:

  • Being widowed
  • Being single
  • Being unemployed
  • Living alone
  • Having a long-term health condition or disability
  • Living in rented accommodation
  • Being between 16 and 24 years old
  • Being a carer
  • Being from an ethnic minority community
  • Being LGBTQ+

The health and financial impact of loneliness

Loneliness can have a huge impact on health, life expectancy and mental wellbeing. Research has shown that loneliness can be as harmful as smoking 15 cigarettes a day or having alcohol use disorder. Moreover, it has also been found to be more harmful than obesity. Not only does this have implications for individuals but also for wider society and the economy.

Recent government research estimated that the wellbeing, health and work productivity cost associated with severe loneliness (feeling lonely “often” or “always”) on individuals was around £9,900 per afflicted person per year. Other research has estimated that loneliness costs UK employers between £2.2 and £3.7 billion a year and that an estimated £1,700 per person (2015 values) could be saved over 10 years if action could be taken to reduce loneliness.

Given the significant health impacts and associated costs, the Mental Health Foundation report argues that preventing the development of loneliness should be a key priority and that a greater awareness of the risk factors and triggers needs to be created.

Public understanding but stigma remains

In terms of public understanding, the report asserts that the public has a good understanding of the link between loneliness and mental health. However, there is still significant stigma surrounding loneliness. Of the adults surveyed, 76% thought ‘people often feel ashamed or embarrassed about feeling lonely’. Only 29% of respondents agreed that ‘people who feel lonely are likely to talk about it, if they get the opportunity’. And people who experience loneliness themselves were more likely to recognise this sense of shame.

This stigma makes it difficult for people to talk about due to fears of discrimination or prejudice. Stereotypes about loneliness also still persist which can lead to some lonely people being overlooked. The findings show that despite the public’s understanding, there is a tendency to overlook certain at risk groups such as students, carers and LGBTQ+ people. People also tend to overestimate the link between loneliness and ageing or living in rural areas.

The survey found that people tended to believe that older people were more likely to feel lonely than younger age groups – 63% thought that being older (over 65) might contribute to someone feeling more lonely, whereas only 12% of respondents identified that being younger (aged 16-25) might contribute to someone feeling more lonely. This contradicts recent ONS data, which found that there were higher rates of reported loneliness among younger age groups.

Similarly, people tended to believe people living in rural areas would be more likely to experience loneliness (40% of people thought that living in a rural area could contribute to loneliness, compared to just 23% for living in a city). However, once again, the evidence suggests the opposite, with people living in urban areas reporting higher levels of loneliness than those in rural areas.

The report notes that stereotypes such as these can inhibit people from recognising and responding to their own loneliness, further exacerbate existing stigma and potentially limit the support offered to those who feel lonely.

Broader awareness

The report argues that a wider understanding of the factors that can lead to severe and enduring loneliness is needed to successfully combat the stigma and stereotypes associated with loneliness.

The stories of the individuals who experience loneliness demonstrate just how complex it is and how difficult it is to spot those who may be ‘lonely in a crowd’. It is therefore also important to understand the different barriers to connection for different people. These can be practical (lack of time, access to transport), structural (discrimination or prejudice) or emotional (lack of confidence, anxiety).

The report argues that a broader awareness of these factors could help people to stop blaming themselves for being lonely, encourage creative ways of supporting people and enable tailored support being developed for groups who are particularly at risk of long-term loneliness.

Previous research has also highlighted the importance of tailored approaches and developing approaches that avoid stigma.

Tackling loneliness

While highlighting what individuals can do to help combat loneliness, the Mental Health Foundation also highlights the need for action on the different barriers to connection if it is be tackled long-term. To this end, it has identified five UK-wide policy recommendations to address loneliness in society:

  • taking a strategic approach to loneliness;
  • developing the community resources needed to tackle loneliness;
  • building a greener lived environment that supports social contact;
  • supporting children and young people with interventions in education settings;
  • ensuring that everyone has access to digital communication technology, and the skills to use it, and respecting preferences for non-digital forms of communication.

Each of us can play a part too. By sharing stories of loneliness and shining a spotlight on the issue, we can all help to promote wider awareness and break the stigma of loneliness.

If you enjoyed reading this, you may also like:

Follow us on Twitter to find out which topic are interesting our research team

From rainbows to Banksy – have lockdowns created a new appreciation for the value of the arts?

Posted on by

Cultural and creative sectors are among the worst affected by the coronavirus pandemic. Recent analysis suggests that jobs at risk in the sector range from 0.8 to 5.5% of employment across OECD regions. In the UK, the arts, entertainment and recreation sector saw the second largest economic decline of all sectors of the economy during the pandemic.

While the negative impact of crises is justifiably focused on, there are often positive opportunities to arise from such shocks such as widespread collaboration and innovative behaviours to find solutions. Indeed, the current pandemic is no different. Amidst the myriad of reports of the dire economic impact emerges a much more colourful picture of a resurgence in arts and creativity across not only the country but the world.

Rising creativity

From the abundance of rainbows displayed in windows across the UK to singers and musicians entertaining their neighbours from their balconies in Italy and elsewhere, the global pandemic has led to many turning to the arts and creative activities in a bid to help each other’s wellbeing and to thank those on the frontline for their heroic efforts to protect us all.

Many young people found new ways to express themselves through creativity during lockdown, whether drawing or making things, creating music or videos to share on social media. Examples of what young people in England have been creating are presented in Arts Council England’s project The Way I See It .

All sorts of artists from across the globe have been sharing their coronavirus-inspired artwork via social media.

The infamous street artist Banksy has also been joining in, creating a variety of new work from rats encouraging people to wear face masks on the London Underground to a piece paying tribute to NHS workers in Southampton General Hospital.

And the industry itself has had to get creative finding new ways to reach people. Many cultural and creative organisations have moved to delivering digital content to keep audiences engaged, which has opened the door for many future innovations. Organisations and individuals have also been doing a variety of work to reach those most in need such as projects creating new programmes or adapting existing work to reach people who are shielding or vulnerable in their homes, overwhelmingly addressing loneliness and isolation. One participant described their experience:

“I found the process of drawing and painting both cathartic and healing at the most difficult time of my life.”

Economic and social value

While there has generally been a need to make the case for the value of arts and creative activity, whether in education or business, perhaps the impact of lockdowns has afforded the opportunity for everyone to recognise their value both at times of crisis and as part of recovery.

The sector is already an economic driver and source of innovation. In 2019, the economic output of arts and culture was equivalent to 0.5% of the whole UK economy. And despite the immediate economic impact of the pandemic, there is hope that the sector will recover quickly, albeit with significant government support. Recent research from the Centre for Economic and Business Research (CEBR) predicts that the sector’s Gross Value Added (GVA) will return to its pre-lockdown level of £13.5bn by 2022 with the help of the Culture Recovery Fund, a full year earlier than was anticipated without government intervention. The research also shows the sector is set to be worth £15.2 billion to the economy by 2025.   

As well as contributing to the economic recovery, the sector can also play a crucial role in the social recovery as indicated by the many examples highlighted above.

As non-educators, many home-schooling parents have moved towards cultural and creative enrichment for their children. It has been well-documented that arts and creative activities can help improve mental health and wellbeing and at a time when there are grave concerns about young people’s mental health, surely this can only be a good thing.

As previous pandemics and disasters have consistently shown, a major focus of recovery needs to be on mental health; something that the arts and creative industries can clearly help with.

Final thoughts

At time when we might all feel like social distancing from ourselves, the arts and creative activities can provide an escape for everyone. The value of arts and culture, both economically and socially, cannot be underestimated. Perhaps the most positive outcome of the current pandemic for these sectors, will be the newfound appreciation of them from all walks of life which will hopefully translate into decision-makers thinking twice before laying the brunt of budget cuts at their door.

Read some of our other posts on arts and culture:

Follow us on Twitter to find out what topic areas are interesting our research team.

‘Bending the Curve’ of biodiversity loss – could Covid-19 be the catalyst for change?

Posted on by

dead forest pic

“The evidence is unequivocal – nature is being changed and destroyed by us at a rate unprecedented in history” (WWF)

The latest Living Planet report from the Worldwide Fund for Nature (WWF) finds that 68% of the world’s wildlife populations have been lost since 1970 – more than two thirds in less than 50 years – with the most striking result a 94% decline in tropical subregions of the Americas. The report says this ‘catastrophic’ decline shows no signs of slowing. The cause – human activity.

Until 1970, the ecological footprint of the human population was less than the rate of the Earth’s regeneration. Explosive growth in global trade, consumption, population growth and urbanisation means we are now using more of the world’s resources than can be replenished:

“To feed and fuel our 21st century lifestyles, we are overusing the Earth’s biocapacity by at least 56%.” (WWF)

The environmental impact of human activity is hardly a new topic but the numerous warnings over the years haven’t had the desired effect of changing society’s trajectory. The stark warnings from recent reports including the 2018 IPCC (Intergovernmental Panel on Climate Change) special report on the impacts of global warming, and popular programmes such as the Blue Planet II series which highlighted the devastating impact of pollution on the world’s oceans, have certainly helped heighten awareness and action has been taken across the world to address the climate emergency. Unfortunately, the progress made so far is not enough to reverse the current declining trends.

But the new report raises hope in that times of crisis new ideas and opportunities for transformation can arise and that the current Coronavirus (COVID-19) pandemic could perhaps be the catalyst for such change.

‘People and nature are intertwined’

COVID-19 has undoubtedly injected a new sense of urgency, emphasising again the interconnectedness of humans and nature. It has provided a stark reminder how unparalleled biodiversity loss threatens the health of both people and the planet.

Factors believed to lead to the emergence of pandemics – including global travel, urbanisation, changes in land use and greater exploitation of the natural environment – are also some of the drivers behind the decline in wildlife.

The report emphasises that biodiversity loss is not just an environmental issue, but also a development, economic, global security, ethical and moral one. And it is also about self-preservation as “biodiversity plays a critical role in providing food, fibre, water, energy, medicines and other genetic materials; and is key to the regulation of our climate, water quality, pollution, pollination services, flood control and storm surges.”

As well the pandemic, a series of recent catastrophic events are used to underline the intrinsic links between human health and environmental health, including: Africa’s plague of locusts in 2019 which threatened food supplies, caused by the unusually high number of cyclones; extreme droughts in India and Pakistan in 2019, leading to an unknown death toll; and Australia’s most intense bushfire season ever recorded, made worse by unusually low rainfall and record high temperatures, as well as excessive logging.

Alongside this, the “extraordinary gains in human health and wellbeing” over the past century, including reduced child mortality and increased life expectancy, are highlighted as a cause for celebration but the study warns that the exploitation and alteration of the natural environment that has occurred in tandem threatens to undo these successes.

Biggest threats to biodiversity

Clearly, biodiversity is fundamental to human life and it is vital that the drivers of its destruction are addressed; and quickly.

Drawing on the Living Planet Index (LPI), which tracks the abundance of mammals, birds, fish, reptiles, and amphibians across the globe, using data from over 4,000 different species, the report identifies the major threat categories to biodiversity:

  • Changes in land and sea use
  • Invasive species and disease
  • Species overexploitation
  • Pollution
  • Climate change

It may be surprising to learn that climate change has not yet been the main driver of biodiversity loss. In fact, globally, climate change features lower on the scale of threats than the other drivers in almost all regions. Changes in land and sea use is the biggest proportional threat, averaged across all regions, at 50%. This is followed by species exploitation at 24% with invasive species taking third place at 13%. Climate change accounts for 6% on average.

However, the report warns projections suggest the tables are set to turn with climate change overtaking all other drivers in the coming years.

But all is not lost yet. The report argues that it is possible to reverse these trends and calls for action to do so by 2030.

‘Bending the Curve’

This year’s report highlights findings from significant new research, the Bending the Curve initiative, which uses pioneering modelling of different human behaviour scenarios aimed at restoring biodiversity. It argues that this has provided ‘proof of concept’ for the first time that we can halt, and reverse, the loss of nature while feeding a growing population:

“Bending the curve of biodiversity loss is technologically and economically possible, but it will require truly transformational change in the way we produce and consume food and in how we sustainably manage and conserve nature.”

2020 has certainly made the whole world stop and think. And it has provided an opportunity to reset humanity’s relationship with nature. Encouragingly, there has been widespread talk of a ‘green recovery’ from the pandemic and the British public have recently backed a “fairer, greener Britain” amid concerns the government might be rushing the country back to a ‘business-as-usual’ model.

Achieving a balance with nature will clearly require systemic change, as the Living Planet report shows. In the words of Sir David Attenborough, “above all it will require a change in perspective”.

Read some of our other blogs related to the environment:

Follow us on Twitter to find out what topic areas are interesting our research team.

An ageing workforce and growing emotional demands call for more sustainable employment

Posted on by

People Turning in Gears - Synergy

As a result of the global demographic challenge of an ageing population and the increasing diversity of working life, there has been a growing focus on sustainable work over the life course which has also placed greater emphasis on the importance of the quality of work and working conditions. As more and more people are having to work longer before retirement, it is important that they are able to do so.

A recent Eurofound report examined working conditions and their implications for worker’s health. Its findings confirmed a clear link between working conditions and the health and well-being of workers, highlighting the need to make work more sustainable.

Working conditions, health and wellbeing

Eurofound’s report found that this relationship can be depicted in a model based on the European Working Conditions Survey (EWCS), showing that health outcomes are the result of two processes: health-impairing processes (exhaustion) and motivational processes (engagement).

Health-impairing processes are associated with exposure to adverse work demands which tend to increase exhaustion, while motivational processes are associated with access to work resources that support engagement.

Such demands can include:

  • physical risks
  • work intensity
  • work extensity (long working hours)
  • emotional demands
  • social demands

Such resources can include:

  • social resources
  • work resources
  • rewards

It is noted in the report that the demand and resources model partly explains how well-designed jobs – characterised by high rewards, high work and social resources and suitable levels of demands – translate into better health: “Whereas job demands are linked to higher levels of exhaustion (which, in turn, are related to poorer health), job resources are associated with higher levels of work engagement (which, in turn, are related to better health and well-being).”

It is therefore suggested that as job control, social resources and rewarding working experiences all have positive effects, employers should be encouraged to introduce initiatives that focus on motivational aspects of work.

As recently highlighted, the discipline of worker health has traditionally focused on worker exposures to various workplace hazards. However, this has more recently broadened to include the concept of worker well-being, which is seen as increasingly important. Not only is it important for the individual but it is an important determinant of productivity for enterprise and society as well. Indeed, the Eurofound report highlights this growing importance.

Emotional demands

While the report notes that physical hazards have a direct effect on worker’s health and wellbeing and are undoubtedly remain important, these have not increased, but emotional demands have. This, it is argued, underlines the growing importance of psychosocial risks. It argues:

“In the context of ageing societies and services-dominated economies, it becomes more pressing to address these risks as the incidence of exposure increases.”

Other research has also highlighted the significance of emotional demands at work in relation to health. One recent study in the Danish workforce, for example, found emotional demands at work predicted a higher risk of long term sickness absence.

With the growing need for long-term care in ageing societies, it is argued that these demands are likely to increase further and, therefore, require particular attention. Different groups of people also face varying demands and are considered in the report. In particular, gender differences are considered throughout – highlighted as significant in some areas

Gender

The report found that men tend to report better health and wellbeing, and fewer health problems and better sleep quality than women. Men were also found to report fewer days of sickness absence and fewer days of presenteeism.

This is consistent with other research findings that show ill-health is more prevalent in women. One study exploring the association between work-related stress in midlife and subsequent mortality, and whether sense of coherence (measured as meaningfulness, manageability and comprehensibility) modified the association, found that occupation-based high job strain was associated with higher mortality in the presence of a weak sense of coherence – a result that was stronger in women than in men.

The Eurofound report findings show that as women often work in sectors like health or education, they are especially exposed to the psychosocial risks associated with these emotionally demanding jobs.

The report also notes that workers under 25 are most likely to face high demands while having the least access to work resources, and health sector employees in particular, face high emotional and social demands. It is therefore suggested that there should be investment in working conditions for particular risk groups, such as occupations requiring lower skills levels, reporting job insecurity, or witnessing workplace downsizing. Measures to promote high union density, good employment protection and gender equality which are likely to improve working conditions and contribute to workers’ health and wellbeing are also highlighted.

Way forward

The findings of the Eurofound report, and indeed other research, highlight the need to look beyond the ‘traditional’, narrower framework of occupational health and safety to include the psychosocial risks such as emotional demands, along with motivational aspects of work. This calls for a reduction in health-impairing conditions and a fostering of health-promoting ones.

Of course, the world of work will continue to change, particularly in an increasingly digital world. However, striking the right balance between demands and resources through coordination between different policy fields could contribute to a higher quality of working life that is sustainable, regardless of the ever changing environment.

Follow us on Twitter to see which topics are interesting our Research Officers this week. If you enjoyed this article you may also like to read:

‘Digital prescribing’ – could tech provide the solution to loneliness in older people?

Posted on by

Notruf und Hilfe für Rentner und Kranke

The number of over-50s experiencing loneliness could reach two million by 2026. This compares to around 1.4 million in 2016/7 – a 49% increase in 10 years.

It has also been estimated that around 1.5 million people aged 50 and over are ‘chronically lonely.’

With an ageing population and increasing life expectancy, it would seem likely that loneliness among older people is set to continue; unless something significant is done. According to Age UK, tackling loneliness requires more than social activities. A new report from Vodafone suggests technology could be the answer.

Impact

The impact of loneliness in older people can be immense, not only for the older people themselves but for those around them. It can also put strain on the NHS, employers and organisations providing support to people who are lonely; and have a negative impact on growth and living standards.

Research has suggested that those experiencing social isolation and loneliness are at increased risk of developing health conditions such as dementia and depression, as well as increased risk of mortality. The damaging health effect of loneliness has been shown to be comparable to smoking 15 cigarettes a day. Older people who are lonely are therefore more likely to use health services than those who are never lonely.

The economic impact is also significant. It has been estimated that increases in service usage create a cost to the public sector of an average £12,000 per person over the medium term (15 years). Vodafone’s report suggests that loneliness has a £1 billion a year impact on public services. It has also been found to cost employers £2.5 billion per year.

How tech can ease the burden

According to Vodafone, “new technologies are a key part of the solution” alongside more traditional public and community services. Two key routes through which technology can be used to reduce loneliness are highlighted:

  • by supporting older people to remain independent in their home and community; and
  • maintaining and building networks and contacts.

From wearable devices and touchscreens to personal robots that act as the eyes, ears and voice of people unable to present physically, these are all highlighted as viable and positive uses of tech to ease the burden of loneliness. And there are already a number of examples of innovative use of technology that can benefit older people.

1024px-AV1

No Isolation AV1 robot. Image by Mats Hartvig Abrahamsen, via CC BY-SA 4.0

Good practice examples

One such example is Vodafone’s smart wearable wristband, the V-SOS Band, which supports independent living while also increasing the wearer’s safety. It can directly alert family members via their phone if the wearer needs help. It also uses fall detection technology so that families can be alerted automatically if the wearer falls either in the home or when they are out.

Kraydel is another example. Its smart TV-top hub links elderly people to their carers or family members, through their TV screens, helping people be more independent and remain in their own homes for longer as well as helping them be more socially connected. It provides for user-friendly video calling via the TV and can help people return home from hospital earlier. Via connection to the cloud, the device interprets the data it receives to build up a picture of the user’s daily activities, health and wellbeing. It issues medicine and diary reminders, and alerts caregivers if it sees something amiss, or identifies potential risk.

Although aimed at children, No Isolation’s AV1 – a smart robot designed to reduce the risks of children and young adults with long-term illness becoming socially isolated – demonstrates the positive impact innovative technology can have on social isolation and loneliness. The robot avatar, with its 360 degree camera, acts as the child’s eyes, ears and voice in the classroom or at other events, keeping children closely involved with school and in touch with their friends.

Of course, loneliness is particularly prevalent among people who don’t use smart technology such as smart phones and tablets, one of the reasons cited by Kraydel for using the TV – probably the most familiar and widely used screen globally. This issue also led No Isolation to develop KOMP, a communication device for seniors that requires no prior digital skills. It enables users to receive photos, messages and video calls from their children and grandchildren, operated by one single button.

Another new project recently launched in Sweden – considered one of the world’s loneliest countries – uses a unique conversational artificial intelligence which enables older people to capture life stories for future generations while providing companionship. Memory Lane works with Google Voice Assistant and is able to hold meaningful conversations in as human a way as possible. A pilot test showed that the software “instantly sparked intimate conversations” and led to stories that hadn’t been told before.

Final thoughts

With a significant number of older people lacking confidence in their ability to use technology for essential online activities, support for digital skills is obviously still important. In response to this issue, Vodafone has launched free masterclasses across the UK, as part of a programme called TechConnect.

Many of the above innovative examples bypass the traditional barriers to realising the potential of technology in reducing loneliness as most:

  • don’t rely on older people engaging directly with the technology; and
  • are based on mobile technology that can be constantly connected, whether inside or outside the home.

However, there is still the issue of awareness of such technologies and their accessibility to older people. The Vodafone report suggests that access could be improved through social and digital prescribing and revitalising support for independent living, and calls for a challenge fund to support innovation. It is suggested that these innovative ideas are just the start and that combined action is needed from across all levels of government, business and community groups, amongst others.

Perhaps if such action is taken to address existing barriers, we will see a reverse in the loneliness trend over the next 10 years.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

Designing for positive behaviours

Posted on by

St Paul's Cathedral, London, England

By Heather Cameron

“We shape our buildings; thereafter they shape us” – Winston Churchill, 1943

This much borrowed saying from the former prime minister was made during the 1943 debate over the rebuilding of the House of Commons following its bombing during the Blitz. Although many were in favour of expanding the building to accommodate the greater number of MPs, Churchill insisted he would like it restored to “its old form, convenience and dignity”. He believed that the shape of the old Chamber was responsible for the two-party system which is the essence of British parliamentary democracy.

Indeed, it has since been widely acknowledged that the built environment has a direct impact on the way we live and work, thus affecting our health, wellbeing and productivity. A new report from the Design Commission, which opens with Churchill’s statement, is described as “a very valuable contribution” to the debate on how the design of the built environment can influence the way people think and behave, “making a healthier, happier and more prosperous and sustainable country”.

Impact of design

The report, which follows a year-long inquiry, is described as providing “solid evidence in difficult areas” on what it is in the built environment that makes people’s lives better. Evidence was gathered on four specific areas believed to be the most important to national policy:

  • health and wellbeing
  • environmental sustainability
  • social cohesion
  • innovation and productivity

It is suggested that design acts at two levels: it can affect individual choices of behaviour, which can then affect health and sustainability; and it can affect the way people are brought together or kept apart, which can then affect communication and creativity, or social cohesion.

The inquiry therefore looked into how people’s behaviour, health and wellbeing are affected by their surroundings; the role design can play in encouraging environmentally sustainable behaviours; the role design can play in social cohesion through its effects on creating or inhibiting co-presence in space; and how the design of work environments can drive innovation and improve efficiency, therefore tackling the current ‘productivity crisis’.

The evidence

The evidence highlights the built environment as “a major contributing factor to public health”. A range of public health issues, including air pollution and obesity, were suggested to be directly linked to factors within the built environment. Other recent research has similarly highlighted this link between health and urban design.

Evidence of the potential for design to positively influence sustainability behaviours, such as greater cycling and walking activity, was also highlighted, with New York cited as a good practice example.

Providing evidence on social cohesion, a senior university lecturer stated that “to divorce the physical from the social environment is inappropriate”. Other submissions referred to the “alienating effects” of various aspects of modern corporate life on civic participation, including estate management, crime and safety, the perceived negative impacts of poorly-conceived urban planning and poor or no maintenance.

Well-designed places, on the other hand, are suggested to improve access and facilitate social cohesion. Nevertheless, the evidence also noted that regardless of how well designed a place may be, “neglecting its aftercare will lead to antisocial behaviour and environmental damage.”

The relationship between the built environment and productive behaviours is supported by substantial evidence, according to the report. In the context of the UK, a lack of access to daylight and fresh air is cited as a reason for offices failing to get the best out of their workers. One study cited, indicated an increase in levels of both wellbeing and productivity in office environments with so-called ‘natural elements’.

Policy – “muddled and fragmented”

While there is evidence of good practice throughout the UK, a principal argument from the report is that more needs to be done.

Policy making for the built environment has traditionally been “muddled and fragmented”, according to the report. It suggests that there is a lack of understanding of the significance of the influence of the built environment on behaviour among policy makers at all levels and therefore makes recommendations for central government, local government and the private sector.

It argues that the relationship between government and local authorities requires reconsideration, calling for greater power at local government level.

Despite encouraging steps with regard to devolution in positively impacting behaviour and quality outcomes, such as in London, it is suggested that more can be done in terms of better collaboration between all stakeholders.

It is also noted that as national policy will be now be conducted in the context of Brexit, adaptation of the regulatory regime will be required.

Final thoughts

The key message from the Design Commission’s inquiry is evidently that the design of the built environment is particularly important in the context of current challenging times for the UK:

 “The way we design our built environment could be one of our greatest strengths in navigating the course ahead… If we get this right, we can build a Britain that is healthier, happier and more productive.”

If you enjoyed reading this, you may be interested in some of our previous posts on related topics:

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

Hidden in plain sight – the value of green spaces

Posted on by

jardin public

By Heather Cameron

They may be something most of us see every day but take for granted – the area of green space we pass on our way to work or frequent in our lunch break. And although we might make use of such spaces on a regular basis, is the true value of them really understood?

As highlighted by a recent report from the Land Trust, green spaces provide even more to society than we often think about.

Wider value

It has long been recognised that green spaces provide multiple benefits to communities and wider society, but there has been limited robust evidence on their wider economic value. The Land Trust report highlights that the services delivered by soil, grass, flowers, trees and water provide society and the economy with significant benefits.

It suggests that several important functions are provided by these green spaces, including:

  • Reducing and preventing flooding
  • Cleaning our water
  • Storing and removing carbon
  • Cleaning our air, reducing air pollution

Such functions help to alleviate costs to local and wider communities, such as to the health service, other public services and local businesses. Previous research has similarly alluded to such benefits.

Independent research by UK scientists in 2011 highlighted the true value of nature in relation to the economic, health and social benefits, estimating that it was worth billions of pounds to the UK economy.

Other research has also shown that green space has been linked to reduced levels of obesity in children and young people, and that access to open spaces is associated with higher levels of physical activity and reductions in a number of long-term conditions such as heart disease, cancer, and musculoskeletal conditions.

The proportion of green and open space is also linked to self-reported levels of health and mental health, through improved companionship, sense of identity and belonging and happiness. And living in areas with green spaces is associated with less income-related health inequality, thereby reducing the effect of deprivation on health.

What the Land Trust’s report does differently, is demonstrate these widely recognised benefits in physical and monetary terms to help create a greater understanding of the economic contribution of well-managed green spaces.

Natural capital accounting

A ‘natural capital accounting’ approach was taken to translate these benefits into financial terms, taking consideration of the physical land, its quality, how it is managed, used and the functions it performs.

Two different parks – Silverdale Country Park in the Midlands and Beam Parklands in London – were used in the study to demonstrate this value. Overall, Silverdale’s annual natural capital value was estimated to be £2.6 million, with a return on investment of £35 for every £1 invested, while Beam Parklands’ natural capital value, based on a 99 year period, has been valued at £42 million – an increase of £21 million since 2009.

Other benefits provided by Silverdale include:

  • Nearly £400,000 per year of flood risk reduction benefits
  • An annual value of £82,000 for the park and its maintenance to retain and purify water
  • A wider annual value of £840,000 of absorbed and stored carbon
  • A potential increase of 113% in local air pollution absorption since 2011

Other benefits provided by Beam Parklands (primarily a flood defence) include:

  • Nearly £600,000 per year of flood risk reduction benefits
  • Nearly £800,000 per year of educational and health benefits to the local community

As two well-maintained green spaces, they indicate the importance of long-term investment.

Final thoughts

Perhaps these financial values will help people to better comprehend the true value of our green spaces. As the report notes, it is important to remember that they are “not ‘one off’ monetary values or price tags” but rather an indication of what our green spaces are worth and their benefits to both society and the economy.

Put simply, as the Land Trust concludes, “green spaces… are valuable to society”.

If you enjoyed reading this, you may also like our previous articles on pocket parks and green spaces.

Follow us on Twitter to see what developments in public and social policy are interesting our research team. 

Basic Income – a simple solution to a complex problem?

Posted on by

By Heather Cameron

“If you want to incentivise work at every level of income then Basic Income is simply the best system.” (RSA, 2015)

Last month MPs in the UK Parliament were asked to consider the question of introducing a universal basic income to be payable unconditionally to all citizens without means-testing or work requirement.

The motion, which was tabled by Green Party MP Caroline Lucas, says the policy “has the potential to offer genuine social security to all while boosting entrepreneurialism”.

While no vote was taken on the policy, and it is unlikely to be made law any time soon, the motion raised the profile of the issue by enabling MPs to add their name in support.

And with ever increasing global interest in the idea, and basic income pilots set to spring into action all over Europe this year, perhaps it’s not as far away from becoming a reality in the UK as we may think.

Pilots

A number of cities and countries across Europe have committed to trialling a basic income.

Last year Finland announced a national basic income experiment, scheduled to start in 2017, which will be the EU’s first nation-wide project. It will see up to 100,000 Finnish citizens paid an unconditional income for a period of two years, after which the results will be analysed to see whether it should be rolled out nationally.

Trials have also begun in the Netherlands. The Dutch city of Utrecht will pay a small group of benefits claimants, whether they work or not, a basic income of £660 a month to provide a basic standard of living and help them avoid the ‘poverty trap’.

In Switzerland, a national referendum on a basic income is planned for this year, and support for the idea has also been reported in France and Canada.

While it is too early to tell whether these pilots will have the desired positive effect, the concept of a basic income is far from new and there have been signs of success from past experiments.

Positive outcomes

In the 1970s, a basic income social experiment, ‘Mincome’, was carried out in the Canadian town of Dauphin, which involved making payments to the entire population, relative to income to cover basic living costs. The programme succeeded in reducing poverty, improving health and alleviating other urban problems.

More recent basic income projects in developing countries have also helped alleviate poverty. In Namibia, a coalition of aid organisations trialled a basic income, funded through tax revenues, of 100 Namibian dollars to each citizen. The result: crime was reduced, children attended school and many villagers used the money to fund micro-enterprises. Meanwhile, in Uganda, a similar programme increased business assets by 57%, work hours by 17% and earnings by 38%.

Critics of such a system say that it would cost the state too much money, and would lead to welfare dependency and a reluctance to work, ultimately resulting in higher unemployment.

A recent survey undertaken in Switzerland would seem to refute this. It indicates that only a very small proportion of the population would stop working if they had a basic income and a majority believe that it would “relieve people from existential fears.”

Similarly, the Canadian experiment found no substantial difference in either female or male unemployment. There were changes in the labour market, as would be expected, with a reduction in working hours within families as a whole. Female spouses reduced their working hours to spend more time with children; and hours were reduced for adolescents within the family who entered the workforce later, suggesting that they were able to stay in education longer.

Way forward for the UK?

The Royal Society for the encouragement of Arts, Manufactures and Commerce (RSA) has recently concluded that there is a strong practical case for basic income in the UK to replace the current tax and benefits system – “it underpins security, replaces the complexity of the current system, and provides a platform for freedom and creativity.”

The RSA report sets out a potential basic income model for the UK. It would provide a universal payment to every citizen, (with restrictions for migrants and those serving custodial sentences). A ‘basic’ amount paid to everyone of working age would provide incentives to work, therefore mitigating against low pay traps of the current system. It would also, the RSA report claims, mitigate against some of the negative distributive effects of basic income schemes by redistributing from higher earners to families with children.

The report calculates household income, comparing the proposed model with the current system of likely Universal Credit/National Living Wage income for 2020/21. In all instances, ranging from single parent families with children under or over five to couples with children under or over five, there was a gain for household income under the basic income model.

With the current welfare system and all its complexity, the new Universal Credit apparently not doing what it’s supposed to and the continued increase in job automation, is this really just a simple solution to a complex problem?

Perhaps by the end of 2016, there will be more evidence for the UK to seriously consider.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

Further reading: if you liked this blog post, you might also like:

Health Champions – “unlocking the power of communities”

Posted on by

Health Cubes_iStock_000022075266Large

By Heather Cameron

“On the societal level, we must understand that health is not an individual outcome, but arises from social cohesion, community ties, and mutual support.” Dr Gabor Maté

Health inequalities have long been an issue in the UK and despite continuous government commitment to tackling them, they continue to persist.

It is estimated that avoidable illness costs around £60 billion and that 1 in 4 deaths are preventable with the adoption of healthier lifestyles. Calls have therefore been made for radical changes in the approach to public health by improving health and wellbeing outside of the core public health workforce.

This is just the approach of the Community Health Champion model, developed by Altogether Better, which has demonstrated not only the positive impact on health but the social value of such an approach.

What are health champions?

Health Champions are volunteers from all walks of life who are provided with accredited training and support so they can undertake health promotion activities within their communities to reduce health inequalities and improve the health of the local population.

The Community Health Champion role began as a five year Big Lottery Funded programme (Wellbeing 1) in 2008. Over 18,000 Health Champions were recruited, trained and supported between 2008 and 2012, reaching over 105,000 people.

Through a combination of their training and own personal experiences, these volunteers empower and encourage people within their families, communities and workplaces to take up healthy activities, create groups to meet local needs and can signpost people to relevant support and services.

Challenges

While Wellbeing 1 succeeded in reaching many people in need, the programme also raised two specific challenges: in almost all cases, the work being done was invisible to the NHS; and securing ongoing funding to continue the support was difficult.

Peer support was later identified as the most appropriate way of trying to connect communities with health services.

Following this recognition and the success of the original model, further lottery funding was awarded to develop the Champion model and use it to engage champions, communities and health services (Wellbeing 2).

Co-production of health and wellbeing outcomes

The model was applied to health services specifically with the aim of addressing the apparent disconnect between the NHS and community-based services. It helps connect both patients with support in their communities and professional practices with those communities.

Many citizens have volunteered in different ways and in different settings. These include:

  • Practice Health Champions working closely with their General Practice to create new ways for patients to access non-clinical support
  • Youth Health Champions where children and young people are recruited, trained and supported to help young people more actively engage with and influence their own and their community’s health
  • Pregnancy and early years Health Champions who are interested in giving children a better start
  • Health Champions working within a specialist, hospital-based NHS service
  • Senior Health Champions who engage with older people, offering a complimentary approach to more formal programmes

Community-based health improvement initiatives such as this could help to strengthen community-professional partnerships and cross-collaboration among health, social and other services. And this in turn could lead to a reduction in health inequalities.

Positive outcomes

According to a recent evaluation of the Health Champions programme, Wellbeing 2 has resulted in a range of benefits:

  • 86% of champions and 94% of participants in the programme reported increased levels of confidence and well-being;
  • 87% of champions and 94% of participants in the programme acquired significant new knowledge related to health and well-being;
  • 98% of champions and 99% of participants in the programme reported increased involvement in social activities and social groups;
  • 95% of practice staff involved with the programme would recommend it and wish to continue.

Other benefits included reduced social isolation, increased levels of exercise/healthy eating and feeling physically better. One champion reported “this has helped me more than any medication might.”

Success stories  include the work of a cycle champion who has improved her own health and wellbeing, encouraged over 70 other people to improve theirs through taking up cycling, provided cycle training to over 50 people in 6 community groups and provided specific detailed help to 5 people.

Other successes have involved volunteers setting up football training, providing support to women with mental health issues, providing advice and support to ethnic minorities and providing advice on healthy eating.

In terms of monetary value, an  analysis of the social return on investment (SROI) of a series of Altogether Better project beneficiaries found a positive SROI of between £0.79 and £112.42 for every pound invested, highlighting the potential value of these initiatives to funders.

Final thoughts

At a time of increasing demands on health services and with the relentless squeeze on public sector resources, perhaps the move towards greater community empowerment and collaboration across sectors is the right one. After all, as I’m sure we’d all agree, prevention is better than cure.

If you liked this blog post, you might also want to read Heather’s earlier post on social prescribing

Follow us on Twitter to see what developments in policy and practice are interesting our research team.

 

 

Social prescribing – just what the doctor ordered?

Posted on by

blue toned, focus point on metal part of stethoscope

By Heather Cameron

It is widely acknowledged that wider social, economic and environmental factors have a significant influence on health and wellbeing. According to recent research only 20% of health outcomes are attributable to clinical care and the quality of care while socioeconomic factors account for 40%.

With increasing pressures on GPs and lengthy waiting times a real issue for many, particularly those with mental health conditions, social prescribing could represent a real way forward.

The government clearly recognised the importance of social prescribing in its new deal for GPs announced earlier this year, which made a commitment to make social prescribing a normal part of the job.

In response to a recent Ask-a-Researcher request for information on different approaches in social prescribing and evidence of what works in the UK, it was interesting to find that despite the recognition of potential value, there has been little evaluation of social prescribing schemes to date.

Much of the material found focused on specific interventions and small-scale pilots and discussion around implementation. A new review of community referral schemes published by University College London (UCL) is therefore a welcome addition to the evidence base as it provides definitions, models and notable examples of social prescribing schemes and assesses the means by which and the extent to which these schemes have been evaluated.

So what is social prescribing?

Social prescribing means linking patients with non-medical treatment, whether it is social or physical, within their community.

A number of schemes already exist and have included a variety of prescribed activities such as arts and creative activities, physical activity, learning and volunteering opportunities, self-care and support with finance, benefits, housing and employment.

Often these schemes are delivered by voluntary, community and faith sector organisations with detailed knowledge of local communities and how best to meet the needs of certain groups.

Social and economic benefits

Despite a lack of robust evidence, our investigation uncovered a number of documents looking at the social prescribing model and the outcomes it can lead to. Positive outcomes repeatedly highlighted include:

  • improved health and wellbeing;
  • reduced demand on hospital resources;
  • cost savings; and
  • reduced social isolation.

According to the UCL report, the benefits have been particularly pronounced for marginalised groups such as mental health service-users and older adults at risk of social isolation.

A recent evaluation of the social and economic impact of the Rotherham Social Prescribing Pilot found that after 3-4 months, 83% of patients had experienced positive change in at least one outcome area. These outcomes included improved mental and physical health, feeling less lonely and socially isolated, becoming more independent, and accessing a wider range of welfare benefit entitlements.

The evaluation also reported that there were reductions in patients’ use of hospital services, including reductions of up to a fifth in the number of outpatient stays, accident and emergency attendances and outpatient appointments. The return on investment for the NHS was 50 pence for each pound invested.

Similarly, the Institute for Public Policy Research (IPPR) has recently argued that empowering patients improves their health outcomes and could save money by supporting them to manage their condition themselves.

IPPR suggests that if empowering care models such as social prescribing were adopted much more widely throughout the NHS we would have a system that focused on the social determinants of health not just the symptoms, providing people with personalised and integrated care, that focused on capabilities not just needs, and that strengthened people’s relationships with one another.

Partnership working

With a continued policy focus on integrated services and increased personalisation, social prescribing would seem to make sense. In addition to providing a means to alternative support, it could also be instrumental in strengthening community-professional partnerships and cross-collaboration among health, social and other services.

The New Local Government Network (NLGN) recently examined good practice in collaboration between local authorities, housing associations and the health sector, with Doncaster Social Prescribing highlighted as an example of successful partnership working. Of the 200 referrals made through this project, only 3 were known to local authority and health and wellbeing officers, showing that the work of social prescribing identified individuals who had otherwise slipped through the net.

And with the prospect of an ageing population and the health challenges this brings, a growing number of people could benefit from community-based support.

As Chair of Arts Council England, Sir Peter Bazalgette, notes “social prescribing is an idea whose time has come”.

Follow us on Twitter to see what developments in policy and practice are interesting our research team.

Further reading: if you liked this blog post, you might also want to read Heather’s earlier post on the health and wellbeing benefits of investing in public art.